A systematic integrative review of the literature on midwives and student midwives engaged in problematic substance use

Abstract

ObjectiveThe objective of this systematic integrative review was to review the literature in relation to problematic substance use (PSU) in midwifery populations. Associated aims were to aggregate existing knowledge about midwives and student midwives' personal engagement in PSU, to generate a holistic conceptualisation and synthesis of existing literature regarding midwives and student midwives personally engaged in PSU and to present new understandings and perspectives to inform the development of future research questions. This review is the first of its kind. Design Systematic searches were conducted in CINAHL, Academic Search Complete, MEDLINE, PSYCInfo, Scopus and the Cochrane Library. Findings were grouped into themes and subthemes relating to both midwives and student midwives and then analysed critically in relation to the wider literature. A quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). The PRISMA statement was used to guide reporting.Setting Included studies were conducted in Scotland, Ireland, Australia and New Zealand. ParticipantsStudies included a total of 6,182 participants. Findings A total of 3 studies were included. All included study types comprised quantitative survey designs, yet one also included a mixed methods design with the use of semi structured interviews. Two overarching themes emerged relating to both midwives and student midwives engaged in problematic substance use. For midwives, three subthemes are described: harmful daily alcohol consumption, working hours and harmful daily alcohol consumption and features associated with harmful daily alcohol consumption. For student midwives, two subthemes are presented: escape avoidance and alcohol, tobacco and cannabis use. Key conclusionsThere is limited evidence available in relation to problematic substance use in midwifery populations in comparison to that available for other healthcare populations. Further research is required and could usefully focus upon midwives and student midwives as distinct professions to be separated out from the wider healthcare workforce.Implications for practice Problematic substance use among the healthcare workforce is associated with an increase in medical errors and inadequate care. Those affected can be reluctant to seek help, experience psychological distress and even contemplate suicide. Whilst evidence remains lacking for midwifery populations, they form a part of the general healthcare workforce and are exposed to similar workplace stressors. As such, it is likely that they would be affected in similar ways.

Changing Responses during the COVID-19 Pandemic: A Comparison of Psychological Wellbeing and Work-Related Quality of Life of UK Health and Social Care Workers

“…The implications of these are for the individuals themselves but also for team and collegiate working, their social networks and patient or user outcomes. In several professional groups there are, as of yet, little baseline data on such activities to enable comparisons or guidance for employers that is relevant to the specific professional activity (see, for example, Pezaro et al's review on midwives' use of problematic substances) [67]. The overall challenges related to NHS funding by recent successive UK governments underpin the many failings evident in declining workforce morale, with industrial action and action short of strikes in health, education and many other sectors.…”

Problematic substance use: an assessment of workplace implications in midwifery

“…Whilst recent studies have focussed upon PSU in nursing populations (5), an integrative systematic review of the literature has revealed a paucity of evidence on PSU in midwifery populations (6). The increased risk to health and impaired functioning in healthcare workers with PSU (7) suggests that if PSU is a significant issue within midwifery it could be an additional factor to consider in addressing current midwifery workforce challenges (8).…”